No single therapeutic modality is best for all keloids. The location, size, and depth of the lesion; the age of the patient; and the past response to treatment determine the type of therapy used.
Prevention is key, but the therapeutic treatment of an existing hypertrophic scar or keloid includes occlusive dressings, compression therapy, intralesional corticosteroid injections, cryosurgery, excision, radiation therapy, laser therapy, interferon (IFN) therapy, 5-fluorouracil (5-FU), doxorubicin, bleomycin, verapamil, retinoic acid, imiquimod 5% cream, tamoxifen, tacrolimus, botulinum toxin, hydrogel scaffold, and over-the-counter treatments (eg, onion extract; the combination of hydrocortisone, silicon, and vitamin E). These therapies have been used to reduce the rate of keloid recurrence after surgical excision, with superficial radiation therapy being the most effective
